Modern medicine and specialism are historically coextensive and all but synonymous. It is understandable, therefore, that the future of medicine is commonly envisaged in the patterns of the immediate past, that is, in the further development and refinement of specialization. Those so persuaded cite the specialties which seem to be springing up before our very eyes, such as enzymology, electrolytic dynamics, and nucleic acid fractionations. In a sort of furor of enthusiasm, they picture the future practice of medicine as an orchestration of virtuosos—each the master of some refined and esoteric department in the clinical score. This vision is enticing, even though it is unrealistic and unhistorical. Essentially, it is foveal in nature, that is, of a pinpoint character and unredeemed by peripheral orientation. It is an uncritical vision that fails to differentiate between the isolated minutiae of research, the extension and perfection of technological processes, and the holism of
Galdston I. THE NATURAL HISTORY OF SPECIALISM IN MEDICINE. JAMA. 1959;170(3):294–297. doi:10.1001/jama.1959.03010030038011
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